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Copyrighted Material BLUKO82-Seeber March 13, 2007 17:50 Index Page numbers in bold represent tables; those in italics represent figures. 10/30 rule, 4 ε-aminocaproic acid (EACA), 81 1-deamino-8-D-argine vasopressin (DDAVP). ␳-aminomethylbenzoic acid (PAMBA), 81 see desmopressin anabolic steroids androgen therapy, 30 A-ANA. see augmented acute normovolemic defined, 21 hemodilution anaphylactic transfusion reactions, 252 acetylstarch, 70 androgen therapy, 30 acute hypervolemic hemodilution (AHH) anemia advantages/disadvantages, 204 acute vs. chronic, 14 defined, 200 adaptive mechanisms technique, 203–04 cardiac output, 14 acute normovolemic hemodilution (ANH) macrocirculation, 14–15 advanced use, 207 microcirculation, 15–17 advantages/disadvantages, 206–07 oxygen extraction, 15 allogenic transfusion exposure, 207 oxygen uptake, 15, 16 and coronary artery stenosis, 204 tissue oxygenation, 16 defined, 200 vascular tone, 14 fractionation, 207 causes history, 200–201 copper deficiency, 40 indications/eligibility, 204 hematinic deficiencies, 45–47 technique of, 204–05 inactivity, 162–63 troubleshooting, 205–06 iron deficiency, 38–40 adenosine triphosphate (ATP) generation, 13, 17 nutritional deficiencies, 46 AHH. see acute hypervolemic hemodilution pressure sores, 163 (AHH) riboflavin deficiency, 44 albumin clinical care pathway, 145 allergic reactions, 72 defined, 9 in AOCs, 115–16 pathophysiology of, 13–17 in coagulation impairment, 71 physiology of, 9–13 human, 271–72 preoperative treatment, 151 in recombinant blood products, 96–98, 103–04 primary prevention, 45–46 in volume therapy, 71 COPYRIGHTEDthresholds MATERIAL for, 9 albumin-based compounds, 87 anemia therapy alginate solutions, 71 androgen, 30 allergic reactions, in fluid therapy, 72 erythropoiesis-stimulating proteins allogenic transfusion. see also transfusions anabolic steroids, 30 defined, 243 EPO, 21–22 effects of, 250–55 NESP, 29–30 history, 4 prolactin, 31 outcome variables, 250–51 rHuEPO, 22–29 alloimmunization, 252 exercise in, 163 alveolar gas equation, 128 fluid therapy, 74 376 BLUKO82-Seeber March 13, 2007 17:50 Index 377 hematinics artificial oxygen carriers (AOCs) background, 35–36 in blood management, 119–20 copper therapy, 40 defined, 110 iron therapy, 36–40 hemoglobin-based, 111–16 hyperbaric oxygen, 136 history, 110–11 oxygen therapy, 135 perfluorocarbons, 116–19 therapy pillars, 18 artificial platelet substitutes, 120–21 anesthesiology, 191 ATP. see adenosine triphosphate (ATP) generation anesthetic measures augmented acute normovolemic hemodilution (A-ANA), controlled hypotension, 193–95 207. see also acute normovolemic hemodilution drug regimens, 196–97 (ANH) fluid restriction in, 197 autologous blood transfusion patient positioning, 192–93 defined, 200, 243 patient warming, 195–96 hemodilution, 203–07 PEEP, 196 history, 200–201 ventilation pattern adjustments, 196 platelet-/plasmapheresis, 207–08 anesthetist responsibilities, 191–92 preoperative donation, 201–03 angioneurotic edema, 271 autotransfusion, history, 4 ANH. see acute normovolemic hemodilution (ANH) balloon tamponade, 185 animal farming, 97 barometric pressure, 127 anticoagulation. see also coagulation Bethesda Units (BUs), 277 in cell salvage, 219 bioethics principles factors beneficence, 288–89 antithrombin III, 270 justice, 289 ␣1-antitrypsine, 271 respect for persons, 288 C1-esterase inhibitor, 271 biologic recovery, 267 human albumin, 271–72 biotechnology, 96 immunoglobulins, 272–75 blood banking ␣1-proteinase inhibitor, 271 bank/clinician interaction, 239–40 protein C, 270–71 blood donation, 228–30 protein S, 271 blood safety, 230–34 history, 3, 4 blood separation, 235–39 preoperative management, 152 defined, 227 anti-D-immunoglobulin, 275 history, 227–28 antifibrinolytics maximum blood order schedule, 240 aprotinin, 79–80 transfusion committee, 240 defined, 77 blood conservation EACA, 81 in blood management programs, 300, 304, 308, 316 PAMBA, 81 defined, 1 tranexamic acid, 80–81 in phlebotomy, 162 antihemophilia factors (classical). see also recombinant clotting in plan of care, 148 factors blood donation rFIX, 99 donor recruitment, 228–29 rFVIIa, 99–102 process, 229–30 rFVIII, 98–99 replacement statistics, 229 antisera, 274–75 bloodless medicine/surgery, defined, 1 antithrombin III, 270 blood loss. see also iatrogenic blood loss ␣1-antitrypsine, 271 adaptive mechanisms, 13 –14 AOCs. see artificial oxygen carriers (AOCs) calculations, 147–48 aprotinin, 79–80 decubital ulcers in, 162 argon beam coagulator, 179 tissue adhesive effects, 86 BLUKO82-Seeber March 13, 2007 17:50 378 Index blood management communication facilitation, 306–07 copper therapy, 40 education, 308–15 current/future practice, 5 hospital administration support, 305 defined, 1 initiator education, 300 HBOCs, 120–21 medical structure, 306 history, 1–2 plan champions, 304–05 iron therapy, 36–40 policies/procedures, 307–08 military uses, 2–3 blood management program, safety oxygen therapy, 135–36 evaluation/benchmarking, 318 PFCs in, 119–20 informed consent errors, 319 plasma fraction(s), 275–79 safety systems, 318–19 principles/laws in, 287–93 blood product contents recombinant blood products/proteins in, 98–105 FFP, 247 vitamin therapy, 40–45 platelets, 246–47 blood management program red cells, 245–46 administration, 5–6 blood safety layers coordinator’s role, 5–6 blood screening, 232 marketing donor education, 230 defined, 299 donor selection/deferral, 231 goals/targets, 315 faults in, 233 nurses’ role, 7 national vigilance systems, 231–32 policies/procedures, 6, 307–08 pathogen reduction, 232, 233 preoperative algorithm, 140 postdonation quarantine, 231 reasons/demand for, 5, 299 blood separation. see whole blood separation blood management program, administration blood storage data collection, 316–17 bacterial contamination, 234–35 priority setting, 315–16 irradiation, 235 routine tasks, 317–18 leukocyte reduction/depletion, 235 blood management program, education storage condition/time, 234 content/evaluation, 310 blood substitutes defined, 299 and AOCs, 111 methods/tools history, 65–66, 228 algorithms, 311–12 military uses, 3 clinical rounds, 311 blood volume conferences, 311 in AHH, 202–03 dedicated programs, 313 in ANH, 205 equipment/drug samples, 314 calculations, 147–48 lectures/grand rounds, 311 estimation methods, 147 one-on-ones, 310–11 and fluid therapy, 66 peer review/audit, 311 and phlebotomy, 161 printed material, 314 viscosity reduction, 14, 74 prospective review, 312 blood washing techniques reading assignments, 312–13 continuous, 215–16 role-plays, 314 discontinuous/intermittent, 214 self-education, 312 filtration, 216 videotapes, 313–14 Bohr effect, 16 needs assessment, 309–10 bone wax, 87–88 participants, 308–09 Boyle’slaw,127 blood management program, initiation BRAND mnemonic administrative structure, 306 alternatives, 255 business plan development, 300–304 decision making, 256–58 BLUKO82-Seeber March 13, 2007 17:50 Index 379 “no transfusion/therapy”, 255 platelet growth factors, 59 transfusion benefits, 248–50 protein C, 271 transfusion risks, 250–55 recombinant factor concentrates, 96–97 Bunsen solubility coefficient, 10 rFVIIa, 100 BUs. see Bethesda Units (BUs) coagulation. see also anticoagulation coaptive, 172 C1-esterase inhibitor, 271 electrocoagulation, 172 cancer factor mixes G-CSF/GM-CSF therapy in, 56 cryoprecipitate, 268 and growth factors, 57 prothrombin complex concentrate, 268 rHuEPO therapy in, 29 microwave, 177–78 transfusion risks, 250 obliterative, 172 tumor cells, 221–22 single factor concentrates cardiac output, 14 factor IX, 269 caregiver role. see iatrogenic blood loss factor VII, 270 cautery, 172 factor VIII, 269 Cavitron ultrasonic surgical aspirator (CUSA), 180 factor XI, 270 cell salvage factor XIII, 269–70 advantages, 217–18 fibrinogen, 269 anticoagulation, 219 prothrombin, 270 blood quality, 216–17 thrombin, 270 blood washing von Willebrand, 269 considerations, 218–19 surgical, 172 techniques, 214–16 in volume therapy, 71–72 cell-saving devices, 212–13 coagulopathies contraindications pharmacological, 153 amniotic fluid embolism, 222–23 preoperative treatment, 151–52 bacterial contamination, 221 tests for, 146 and concomitant diseases, 223 cobalamins, 42–43 tumor cells, 221–22 Cohn’s fractionation, 3 defined, 211 collagen, 88 direct/indirect, 212 colloid(s) filtration, 219 defined, 65 history, 211–12 history, 65 indications for, 223–24 solutions methods/devices, 3, 212–13 acetylstarch, 70 risks/side effects, 219–21 albumin, 71 cell-saving devices, 3, 212–13. see also cell salvage alginates, 71 Charles’ law, 127 dextran, 70 charters/bills/laws gelatins, 70–71 advance directive, 291 HES, 69–70 informed consent, 290–91 colony-stimulating factors, defined, 50 international examples, 289–90 compassionate use minors, 291–92 defined, 287 pregnancy/motherhood, 291 FDA protocol, 296 clinical trials compression and compassionate use, 287 balloon tamponade, 185 HBOCs, 115 bandaging, 184 hemostatic drugs, 85 manual wound, 183–84 increased FiO2, 205 mesh wrap, 184–85 interoperative plateletpheresis, 201 packing, 184 BLUKO82-Seeber March 13, 2007 17:50 380 Index conjugated estrogens electrocautery defined, 77 defined, 172 as hemostatic drug, 84 tool, 176 controlled hypotension electrocoagulation, 172 concept of, 193–95 electrosurgery, 176–77 fluid restriction in, 193–94 electrothermal bipolar vessel sealing, 177 induction agents, 194 EPO. see erythropoietin (EPO) regional/epidural anesthesia in, 194 eptacog, 99–102 vasodilatation drugs in, 194 erythropoiesis copper deficiency/therapy, 40 EPO in, 22 coronary artery stenosis, 204 hematinics
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